the establishment of a restaurant or supermarket. Nevertheless, there are policy arguments to make to city councils and state legislators regarding zoning and general plan requirements that, for example, limit how many fast food restaurants can exist in a community. An example is the move to limit liquor stores in South Central Los Angeles two decades ago, which spawned a community coalition that had a significant impact.

In response to a question about whether the community involved in obesity issues has worked with the architecture and design communities responsible for the Leadership in Energy and Environmental Design (LEED) program, Ashe observed that the 2009 strategic plan for the Department of Housing and Urban Development referred specifically to “healthy housing” that would, for example, reduce the occurrence of asthma and injuries. A new frontier is to move public health standards into the home in creating an environmentally sustainable community.

Russell Pate, who moderated the session on physical activity as a member of the Standing Committee on Childhood Obesity Prevention, said that the failure of schools and districts to comply with state mandates on physical education is a national phenomenon. It is difficult to monitor both the quantity and quality of physical education, and even schools that emphasize physical education can fall short by, for example, releasing students for advanced placement courses.

Garcia observed that one reason schools give short shrift to physical education is that they are drilling students to perform well on mandated tests. One response would be to mandate and enforce physical education standards. For example, physical education could be a standard that schools would have to meet to receive federal funding. Garcia’s group also is analyzing data from 200 schools that have been audited in the past 5 years, 100 of which do not enforce physical education requirements, looking for patterns of noncompliance and racial discrimination. In addition, if the federal government were to help enforce physical education standards in the worst schools, there would be a trickle-up effect, Garcia said, as other schools realized that physically fit students do better academically.

Kelly Brownell of the Standing Committee on Childhood Obesity Prevention, asked whether data exist showing that physical activity increases as people have greater access to open space, which would buttress the civil rights argument. Garcia responded that The Robert Wood Johnson Foundation released a report in April 2010 on access to parks and increases in physical activity. Guidelines issued by the Centers for Disease Control and Prevention and the IOM provide additional information on the links among healthy food, physical activity, and obesity prevention.



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